Therapeutic agents for treating pain, inflammation, and fever include analgesics, anti-inflammatories, and antipyretics. Non-steroidal anti-inflammatory drugs (NSAID's) are one type of such therapeutic agents. They include propionic acid derivatives, acetic acid derivatives, fenamic acid derivatives, biphenylcarbodylic acid derivatives, oxicams, and cyclooxygenase-2 (COX-2) selective NSAID's.
Propionic acids include for example ibuprofen, naproxen, and ketoprofen. Ibuprofen in particular is a widely used, well known NSAID possessing analgesic and antipyretic properties. Ibuprofen is chemically known as 2-(4-isobutylphenyl)-propionic acid. It has been commercially available as an over-the-counter drug in many forms for several years.
NSAID's are typically administered on a once to four times daily basis, with the daily dose ranging from about 50 to about 2000 milligrams, preferably from about 100 to 1600 and most preferably from about 200 to about 1200 milligrams.
It is known to administer NSAID's and other drugs in multiple doses over 12 or 24 hours. For example, it is known to administer multiple doses containing equal amounts of ibuprofen over 12 to 24 hours. Sustained release dosage forms containing ibuprofen are also known.
Palmisano et al., Advances in Therapy, Vol. 5, No. 4, July/August 1988 reports on a study of ketoprofen and ibuprofen for treating primary dysmenorrhea. This reference discloses the use of multiple doses of ketoprofen (initial dose of 150 mg followed by subsequent doses of 75 mg) and ibuprofen (initial dose of 800 mg followed by subsequent doses of 400 mg).
A double-blind, randomized, parallel, placebo-controlled, single center, PK/PD dental pain study was conducted over a 12 hour observation period to evaluate the pharmacokinetic, pharmacodynamic, efficacy and safety profiles of certain ibuprofen dosing regimens. Specifically, a single dose of 600 mg ibuprofen extended release caplets was compared with equivalent total doses of ibuprofen immediate release 200 mg caplets administered in three different dosing regimens as well as placebo in the treatment of moderate to severe post-operative dental pain. The ibuprofen was administered as ibuprofen extended release 600 mg caplets or one or more ibuprofen immediate release 200 mg caplets. One sub-group of patients had both pharmacokinetic and pharmacodynamic evaluation (PK group). The other sub-group of patients had only the analgesic efficacy evaluations (non-PK group). Patients from both subgroups were assigned at random to one of the five following treatments:
Ibuprofen Extended Release600 mg single dose at 0 hourIbuprofen Immediate Release600 mg single dose at 0 hourIbuprofen Immediate Release400 mg at 0 hour; 200 mg at 4 hoursIbuprofen Immediate Release200 mg at 0, 4, and 8 hoursPlacebo
Patients' assessments of pain intensity and pain relief as well as blood samples for plasma ibuprofen analysis were obtained at the study site at hours 0, 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 4.5, 5, 6, 7, 8, 8.5, 9, 10, 11 and 12. A stopwatch technique was used to measure the onset of meaningful pain relief. The study found that the 400/200/0 administration of ibuprofen provided excellent pain relief over the entire 12-hour study period. During the first four hours, the 400/200/0 treatment, along with the 600/0/0 immediate release treatment, provided superior pain relief over the other treatments. During the 4 to 12 hour interval, the 400/200/0 treatment alone provided the highest pain relief scores, despite the fact that no further ibuprofen was administered after the first four hours.
Applicants have now discovered that ibuprofen can be provided to a mammal, preferably a human, in a specific single dosing step to achieve improved therapeutic effect, especially pain relief, compared with known dosing regimens and in a more convenient/compliant dose form. In particular, ibuprofen is provided to the mammal, in one dosage form to provide an initial immediate release dose followed by a delayed second sustained release dose of ibuprofen. No further dosings are required to provide a Cmin of 5-10 mcg/mL for a period of at least about 8 hours after administration of the dosage form.